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This article asks, \u201cAre obstetric fistulas best repaired locally, at the district hospital where more women would have greater access, or is it necessary to provide these services at a tertiary referral or fistula center, where specialized surgical procedures can be conducted? Each possibility has advantages and disadvantages. The author concludes that 3 critical factors are necessary to provide safe and effective fistula repair services: adequate, long\u2010term funding to cover the costs of all aspects of the care; the presence of a surgeon who is a \u201cfistula champion\u201d; and adequate operating theatre time and supplies. Without external funding, these prerequisites are almost impossible to meet at rural district hospitals.<\/jats:p><\/jats:sec>","DOI":"10.1016\/j.ijgo.2007.06.019","type":"journal-article","created":{"date-parts":[[2007,8,29]],"date-time":"2007-08-29T11:12:04Z","timestamp":1188385924000},"source":"Crossref","is-referenced-by-count":12,"title":["Where should obstetric vesico\u2010vaginal fistulas be repaired: At the district general hospital or a specialized fistula center?"],"prefix":"10.1002","volume":"99","author":[{"given":"L.L.","family":"Wall","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2007,8,28]]},"reference":[{"key":"e_1_2_7_2_2","volume-title":"Essential obstetric functions at first referral level to reduce maternal mortality","author":"World Health Organization","year":"1986"},{"key":"e_1_2_7_3_2","doi-asserted-by":"publisher","DOI":"10.2190\/91YH-A52T-AFBB-1LEA"},{"key":"e_1_2_7_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006254-199609000-00024"},{"key":"e_1_2_7_5_2","volume-title":"Market driven health care: who wins and who loses in the transformation of American's largest service industry","author":"Herzlinger R.","year":"1997"},{"key":"e_1_2_7_6_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1464-410x.1999.00197.x"},{"key":"e_1_2_7_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-200212000-00026"},{"issue":"1","key":"e_1_2_7_8_2","first-page":"S1","article-title":"The obstetric vesicovaginal fistula in the developing world","volume":"60","author":"Wall L.L.","year":"2005","journal-title":"Obstet Gynecol Surv"},{"key":"e_1_2_7_9_2","first-page":"182","article-title":"Report of a pilot project on the rapid training of pelvic surgeons in techniques of obstetric vesico\u2010vaginal fistula repair in Ghana and Nigeria","volume":"2","author":"Elkins T.E.","year":"1996","journal-title":"J Pelvic Surg"}],"container-title":["International Journal of Gynecology &amp; Obstetrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1016%2Fj.ijgo.2007.06.019","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1016%2Fj.ijgo.2007.06.019","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/api.elsevier.com\/content\/article\/PII:S0020729207003670?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/api.elsevier.com\/content\/article\/PII:S0020729207003670?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.ijgo.2007.06.019","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T10:11:26Z","timestamp":1695550286000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1016\/j.ijgo.2007.06.019"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2007,8,28]]},"references-count":8,"journal-issue":{"issue":"S1","published-print":{"date-parts":[[2007,11]]}},"alternative-id":["10.1016\/j.ijgo.2007.06.019"],"URL":"https:\/\/doi.org\/10.1016\/j.ijgo.2007.06.019","archive":["Portico"],"relation":{},"ISSN":["0020-7292","1879-3479"],"issn-type":[{"value":"0020-7292","type":"print"},{"value":"1879-3479","type":"electronic"}],"subject":[],"published":{"date-parts":[[2007,8,28]]}}}